{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELLE O HAASE","gend":1,"add":"2600 OLD WOLF CREEK ROAD","city":"NARROWS","state":"VA","zip":241242561,"dob":"2006-10-27","age":"","mstatus":"","insh":8117647,"cliId":"","pno":5407268025,"cno":"","email":"","ename":"","eno":"","pphy":"HARDEE, ABRAHAM B","ppno":"","pcpadd":"215 Roanoke St","pcpcity":"Christiansburg","pcpstate":"VA","pcpzip":240733025,"pcpcounty":"","pcpid":"P0124319","pcpname":"FREE CLINIC OF THE NEW RIVER VALLEY"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["K59.00","M41.124","F84.0","R62.50","M99.00","M99.01","M99.02","M99.03","R68.89","R05","M41.9","M41.85","E55.9","Z79.899","Z01.812","G89.18","M41.129","D62","M41.05","M41.125","M41.24","R00.0","M41.25","M41.26","K59.09","F80.2","Z98.1","R15.9","R29.91","R41.83","Z48.89","M41.126","Z98.890","Z47.89","K59.01","Z00.121","Z23","M62.81","H53.003","H50.10","J01.90","J30.9","Z30.8","Z30.09","Z30.017","N93.9"],"date":["2018-12-03","2019-01-30","2019-12-20","2019-12-20","2018-12-03","2018-12-03","2018-12-03","2018-12-03","2019-05-03","2018-12-23","2020-02-26","2018-12-23","2019-06-27","2019-01-07","2019-01-07","2019-03-11","2019-08-07","2019-01-16","2019-02-06","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-01-14","2019-02-13","2019-01-14","2020-02-26","2019-01-16","2019-03-11","2019-08-07","2019-03-11","2019-01-30","2019-03-13","2019-07-24","2019-02-13","2019-03-29","2019-11-08","2019-05-03","2020-08-26","2020-08-26","2020-03-27","2019-12-16","2019-12-20","2020-01-20","2020-01-28","2020-06-02"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""]]]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":""}]}]}